7/15/2015
Jessica Clements
• Understand various types of
supervision
• Review development
of a supervision plan
• Describe ways to
demonstrate and
document competency
• The act or function of supervising
•Supervise: To oversee (a process, work,
workers, etc.) during execution or
performance; superintend; have the
oversight and direction of.
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7/15/2015
• Personal – The supervisor is present in the room
when the service is being performed
• Direct – The supervisor is “immediately
available” or “physically present, interruptible
and able to furnish assistance and direction
throughout the performance of the procedure
• General – a service is furnished under the overall
direction and control of the supervisor, but his or
her physical presence is not required during the
performance of the procedure
• Direct – the supervising physician is physically
present with the resident and the patient
• Indirect –
• Immediately available – the supervising physician is
physically within the hospital or other site of patient care,
and is immediately available to provide direct supervision
• Available – not physically present on site, but immediately
available by means of telephonic and/or electronic
modalities, and is available to provide direct supervision
• Oversight – the supervising physician is available
to review procedures and encounters and to
offer feedback after care is delivered
• Direct reports, peers, other professionals
• Medical physicist in training
• Qualified Medical Physicists
• Medical Physicist Assistants
• Clinical staff
• Clerical staff
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• State or local regulations may require
supervision for medical physics
activities performed by non-QMPs
• Billing for professional services may
entail an implied or explicit
requirement that services are
provided by a QMP
• If a QMP delegates work to a nonQMP (trainee or medical physicist
assistant), the QMP is still responsible
for the work of the supervised
individual
• In Texas, there’s guidance for
supervision of medical physicists in the
board certification process that are
licensed as Temporary Medical
Physicists.
• https://www.dshs.state.tx.us/
mp_guidance.shtm
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• Supervisor assumes professional
responsibility for the work done by the
trainee
• Supervisor teaches the trainee in regular,
high quality interactions
• There’s a general progression of supervision
(As the trainee gains more experience, the
level of supervision is adjusted)
• The supervisor “signs” all work by the trainee
• Recommended as a written document describing
the tasks delegated and the required supervision
level for each task
• Competency – demonstrated ability to perform the
medical physics-related task or function
independently
• Formal work product – deliverable or outcome that
must be produced as part of the clinical work to
complete a project and achieve its objectives
• Cosign or Cosignature – a second signature or the
formal process of finalizing of a formal work
product by a supervisor
• Regulatory or compliance
• Validating safety procedures
• Needed for new equipment or procedures
• Verifying that training was effective
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http://www.jointcommission.org/standards_information/
jcfaqdetails.aspx?StandardsFaqId=32&ProgramId=47
• As a supervisor, you need the following knowledge:
• Technical
• Medical physicists have a lot of technical knowledge with respect to
medical physics
• Also need management fundamentals
• Operational
• How do things work in your facility
• Political
• Needed to influence effectively in the political environment that exists
in all organizations
• Establish trust
• Supervisees must feel safe and know that the supervisor has their best
interest
• Tell the truth
• Follow through
• Explain how and why you do things
• Instead of lecturing, coach. Ask good questions.
• “What do you think about...?”
• “Have you thought of…?”
• “Would you consider…?”
• Really listen to them
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• 1) Identify competencies and who needs what
• Could be technical and behavioral (critical thinking, core values, soft skills)
• Should cover at minimum, items in the job description
• 2) Choose a verification method for each competency
• Direct observation/demonstration, self directed, proof of prior
experience, case studies, self assessment, evidence of daily work,
presentation or verbal demonstration of knowledge
• 3) Ensure consistency in competency demonstration
• 4) Decide how competency will be scored
• Pass/Fail or scale with multiple levels
• 5) Determine how will the results be used and shared
• How will unsatisfactory assessments be managed?
• Tied to compensation?
• Supervisor
• Determines what competencies need to be documented
• Ensures the environment promotes timely competency assessment and
ongoing growth and development
• Provides education as needed
• Monitors supervisee progress, ensures appropriate documentation
• Supervisee
• Complete competencies on time
• Have a contributing role to developing competencies and evaluating the
process
• A form or log with various technical skills listed
• Dates and results are documented
• Actions:
• Observed in practice
• Demonstrated/Simulated practice
• Test/Self Study
• Verbalized Understanding
• Ratings:
• Satisfactory
• Unsatisfactory
• Simple documentation that can cover many technical
competencies
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7/15/2015
• Policies and procedures
• Documentation of how a task is to be
performed
•Established expectation
•Policies include overall scope, frequency,
and outcomes
•Procedures are detailed instructions
•Reviewed on a regular basis by supervisors
and supervisees, updated as needed –
generally annually
• A process where competency is
established for independent performance
of a task per established policies and
procedures
• Typically includes documented training
and attestation by the supervisor that
they have witnessed the supervisee
perform the task appropriately
• Documented competency, usually on
an annual basis, by review of work,
observed performance, testing, etc.
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• Set clear expectations, rewards and consequences
• Your common sense may not be their common sense
• It’s important to communicate how their work fits
into the big picture and what matters
• Specify timelines
• Let supervisees know how performance will be
evaluated and what they need to do to get a
positive evaluation
• Encourage questions
• After communicating something, ask
them to explain it back to you
• When a project is established with a
timeline, check in occasionally
• Explain the “why” of the expectations
• Do staff have the necessary tools,
training, and time?
• Give regular feedback
• Make yourself available
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• Supervision is important for ensuring safe practices and
demonstrating compliance with regulatory and accreditation
standards
• The process should include input from supervisors and
supervisees and be conducted in a trusting and safe
environment
• Formal demonstration of competency is essential for new
procedures or supervisees and must be monitored on an
ongoing basis – competency is fluid
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